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A Physician’s Gratitude Manifesto

I’ve spent many hours reflecting on those persons and things that I am grateful for recently. I frequently think I should tell them all individually, but the list is daunting, life happens, and I don’t. Now that I am out of some of the toughest years of my life however, I realize I very likely did not act in a way that would have demonstrated my gratitude at the time. Truth-be-told, my priority was being empathetic and loving for my patients and son, and keeping my fresh all too stressed marriage intact. I was in “survival mode” through much of my residency and fellowship being a new-mom married to another resident and with a young child. Something always has to give when one takes on too much, and for me, I suspect it was my ability to remain gracious in my interactions with colleagues, team-mates, and even sometimes friends. I won’t apologize (largely because I’m trying to drop the habit of excessive apologizing that I and many strong women are plagued with). Instead, I want to recognize those colleagues, mentors, teachers, and institutions that meant the world to me and helped me become the intelligent, thorough, caring, honest mom-doctor I am today. Maybe they already knew I was grateful, but based on how I probably acted, I doubt it. And really, is there such thing as receiving too much thanks? I don’t know any person that would honestly say so.

Where to start? Well, there is the obvious. I am always grateful for the honor and privilege to care for my patients (and their families) and their trust and confidence in me. Then there’s my own family. People often take things out on the ones that are closest to them. No doubt some of my stress was taken out on my family (mostly immediate family). And yet, they have always been there for me, they have been my foundation, and they always will be. Even my extended family, of which there are many, have stepped up when they’ve heard my beckoning cry. Then there are my friends from grade-school on up through life-stages who have not judged me for dropping off the face of the earth at times, who have welcomed me back excitedly when I resurfaced, who have literally had to force me into kicking back and having fun, who have initiated keeping in touch when I’ve failed at it, or who have even just “liked” my facebook or instagram posts despite me not ever seeing theirs just to show they are still interested. Sometimes the gestures are bigger, and I haven’t been able to express the love and appreciation I have felt. Well, all of it has mattered to me. So thank you.

I’ve had many teachers in my life. My middle school science teacher Mr. Blesse inspired my love for science, and my freshmen high-school biology teacher Mr. Harbaugh sealed the deal for my fate. And yet, I’m also extremely grateful that I had a well-rounded liberal arts education. I am grateful to, at both East High School in Denver, CO and college at Notre Dame, the non-science teachers I had who helped mold me into the well-rounded person I am today.

I’m beyond honored to call myself a graduate of Loyola Stritch School of Medicine. The teachers, attending physicians, scientists, staff, educators, priests and students there all had the common goal of being people of service to others. I wish I could individually name everyone, but this would be far too long, because there were too many amazing people. I just watched Pamela Wible’s commencement speech at Loyola Stritch. It was amazing, and many of my same teachers were sitting behind her, I am overjoyed to say.

I’ve saved the most needed for last. Or really, those who probably got the worst of me during my most difficult years but also were there, present, supporting and molding me for the better. First and foremost, I must thank my friend, sister really, Nicole, who was my neighbor and partner in navigating new motherhood during my time in Lancaster County. Without her friendship and her entire family’s support and her daughter’s affinity for my son, I do not think I would have survived residency. Truly.

I am forever indebted and fortunate to have matched to the Lancaster General Hospital Family Medicine Residency. Let’s start with my co-residents, particularly my class. I was one of thirteen of some of the most amazing and unique individuals I have ever known who are now attending family physicians serving others. I’m no longer in touch with 60 percent of them, but I think of them often. At the time, I was the only of the intern class with a child and one of the only married persons. I can’t say that all of my colleagues knew what I was going through, but I will say definitively, it didn’t matter. They treated me with love, kindness, respect and support, even when I probably didn’t return the favor or came-off as too frigid to care. Even when I acted like we weren’t “in-it-together” because I was too overwhelmed by my own burdens, they kept me grounded and “in-it” in individually unique but essential ways. Humor, benign pranks, empathy, true presence in the face of suffering, understanding, love, resilience. These are the types of qualities LGH looks for and consistently finds in its matched residents and I couldn’t be more grateful that I had chief residents and fellow resident classmates with these qualities. I wouldn’t have made it otherwise.

Then, of course, my nurses. Or rather, our nurses. And frankly, the entire family med clinic office staff and the nurses who staffed the wards of LGH. It is not easy to nurse a resident clinic or service. Our nurses in both of our continuity clinics patiently guided us, and me, through our patient encounters. They did my dirty work (computer crap I couldn’t figure out, giving shots, prep work, the list goes on and on) and kindly gave me tips when I was truly a newbie. They tolerated my potty-mouth directed at the EMR (and life’s crap) at my working station. Nurses, as a whole, are the heart and soul of medicine. And no good physician becomes a good physician without the help of a good nurse. So thank you!

The culture of a place is reflected from top to bottom. It was obvious in my fellow residents and it started from the top. Dr. Z the retired program chair maintained a presence. The new program chair Dr. R brought quiet wisdom and optimism. The male attendings were knowledgeable and simultaneously kind in redirecting us when necessary in our medical care. The role-model women attendings exuded strength, wisdom, love, care and knowledge…..and moreover, empathy for what I was going through. Almost all of them were, like myself, mothers. On top of that, they were amazing physicians. All of my attendings had a variety of personalities (many different from my own), which I am grateful for, as it helped me understand the diversity in my own chosen field and thus the possibilities. I can’t name or reference each one, but a few I must. Dr. C, who gave me a scarf after the worst night of my on-call life. It had been a rough month and a patient I felt close to died on my watch. In hindsight, I believe his death was inevitable and really didn’t have anything to do with me, but I can’t help but feel responsible for when and how he died. Dr. C and my attending on call that night showed me love and compassion. No blame, just care. Maybe they knew me well enough to understand that I would unnecessarily blame myself. Either way, I still have and cherish the scarf. It’s actually really cute, but more importantly a reminder to me that I have a village that cares, that I can’t control everything, and that it’s ok. Thank you Dr. C. To my “advisor” Dr. F, I don’t think I was easy to “advise”, especially since you were a new attending to our program. But, you let me do me, and that’s what I needed. Thank you. To the dynamic duo Dr. R and Dr. K, thank you for your love for life, your music, and your advice. I know I didn’t seem receptive, at the time, I couldn’t handle much beyond the day to day and yet I put on a strong front. But, you made a difference in how I love, empathize, abstain from judgement, and now take care of myself (I tried yoga!). To all of my attendings and teachers during my time at LGH family medicine residency: I can’t name you all but that’s not because I don’t want to: thank you, thank you, a million times thank you.

But LGH is not finished. They also served as my Geriatrics Fellowship. I have now been to a few different states, met a few other Geriatricians (my father is one), and been faculty in a Geriatric Fellowship. What LGH offers is uniquely exceptional in creating clinically superb in any setting Geriatricians, and this is in no small part due to the outstanding clinical mentors and program LGH has developed. I was not a peach while in fellowship either. That year, my husband was finishing his toughest year of residency, we’d discovered that a prior live-in nanny was a felon, and a loved one of mine committed suicide. And yet, my mentors there cared for me, taught me, and most importantly were patient with me. Thank you. Thank you. Thank you.

My favorite quote, ever since I first heard it, has been this, “We must learn to regard people less in the light of what they do or omit to do, and more in the light of what they suffer.” – Dietrich Bonhoeffer. Well, I have omitted expressing my gratitude for far too long. I am sorry that I wasn’t able to sooner because of what, at the time, I suffered. Nonetheless, I am eternally grateful to those who have been patient with me, loved me, forgiven me, befriended me, even tolerated me during my worst years. And now that I’m out of it, I’m also able to appreciate the love and support I’ve had all along from family and friends. This will be too long for a popular medical blog (like kevinmd) to publish (well over 1,000 words). I don’t think I can make it shorter. However, if you are someone who knows me, or someone who doesn’t but also appreciates gratitude for your care and love, please share on FB, or tweet, or pass along. I am not in touch with all the amazing people who I am grateful for who have influenced me in various ways. Yet, I want them to know I am grateful. It means the world to me, although never expected, when a patient or family sends me a note or message thanking me. It keeps me going, and helps me continue to be the best doctor I can be. Perhaps this could be that for some of the friends and mentors/teachers who certainly influenced me for the better but never received any acknowledgement from me at the time. So it can reach those it’s intended to, feel free to make it viral.

To everyone I mentioned above and the many who I may have missed who have been part of my journey: From the bottom of my no-longer guarded heart: THANK YOU!!!!!

This is beautiful, Shannon! Thanks for writing this. As one of your long-lost grade school friends who still loves you and would love to see you, let’s get back in touch! Where are you these days? Please reach out if you are in Denver.